Case | Species | Antibiotic resistance phenotypea | Carbapenemaseb | First acquisition on the HSCT unit | Colonization | Subsequent infection with the colonizing CR GNB | Antibiotic treatment of infection | Decolonization procedure |
---|---|---|---|---|---|---|---|---|
1 | Escherichia coli | Piperacillin/Tazobactam: R Ceftazidime: R Fluroquinolones: R Gentamicin: R Meropenem: I (8) Ertapenem: R (> 2) Imipenem: I (4) Colistin: S Ceftazidime/Avibactam: S Ceftozolan/Tazobactam: S | Not detected | Yes (after HSCT) | Yes (rectal) | No | – | No |
2 | Escherichia coli | Piperacillin/Tazobactam: R Ceftazidime: R Gentamicin: S Fluroquinolones: R Meropenem: S (0,5) Ertapenem: R (2) Imipenem: S (≤1) Colistin: S Ceftazidime/Avibactam: S Ceftolozan/Tazobactam: S | OXA-48 | No, already known at admission (prior to HSCT) | Yes (rectal, groin) | No | – | No |
3 | Acinetobacter baumannii | Piperacillin/Tazobactam: R Ceftazidime: R Gentamicin: R Fluroquinolones: R Meropenem: R (> 16) Imipenem: R (> 8) Colistin: S Ceftazidime/Avibactam: R Ceftozolan/Tazobactam: R | Not detected | No, already known at admission (prior to HSCT) | Yes (rectal, groin, naso-pharyngealc) | Yes (BSI), onset prior to HSCT | High dose meropenem, amikacin, colistin | Yes: Decolonization of skin, oral and nasal mucosa with octenidine-dihydrochloride |